ObjectiveTo investigate the association between serum fasting triglyceride glucose-body mass index （TyG-BMI） and new-onset metabolic dysfunction-associated fatty liver disease （MAFLD） within 10 years. MethodsA retrospective analysis was performed for the data of individuals who underwent physical examination in The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University in 2013， 2018， and 2023 and were not diagnosed with MAFLD in 2013， and a total of 1 340 valid subjects were enrolled according to the inclusion and exclusion criteria. The gbmt package in R 4.3.0 was used to construct the dynamic change trajectory model of TyG-BMI， and four different TyG-BMI trajectory groups were determined， i.e.， the low-level group （n=352）， the medium-level group （n=517）， the high-level group （n=314）， and the extremely high-level group （n=157）. The data on general information and blood biochemical parameters were collected from all subjects and were then compared between groups. The chi-square test was used for comparison of categorical data between groups， and the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data with heterogeneity of variance between multiple groups. The Cox regression analysis was used to investigate the association between different TyG-BMI trajectories and the risk of MAFLD， and the receiver operating characteristic （ROC） curve was used to assess the value of TyG-BMI in the diagnosis of MAFLD. ResultsThe cumulative incidence rate of MAFLD increased with the increase in the level of TyG-BMI trajectory， with a cumulative incidence rate of 4.83% in the low-level group， 29.98% in the medium-level group， 61.15% in the high-level group， and 83.44% in the extremely high-level group （P<0.001）， and the cumulative incidence rate of MAFLD in men was significantly higher than that in women （51.34% vs 20.67%， P<0.001）. The multivariate Cox regression analysis showed that increases in the levels of TyG-BMI trajectory， uric acid， diastolic blood pressure， hemoglobin， and alanine aminotransferase were independent risk factors for the onset of MAFLD （all P<0.05）， while the increase in high-density lipoprotein cholesterol was an independent protective factor against MAFLD （P<0.001）. After adjustment for confounding factors， the medium-， high-， and extremely high-level groups had a hazard ratio of 4.430 （95% confidence interval ［CI］： 2.660 — 7.377， P<0.001）， 6.937 （95%CI： 4.110 — 11.708， P<0.001）， and 7.989 （95%CI： 4.616 — 13.827， P<0.001）， respectively. The ROC curve analysis showed that TyG-BMI had the highest diagnostic value， with an area under the ROC curve of 0.859 （95%CI： 0.840 — 0.879）， a sensitivity of 79.8%， and a specificity of 76.3%. ConclusionThe risk of MAFLD increases with the increase in the level of TyG-BMI trajectory， and TyG-BMI can be used as a predictive indicator for MAFLD.

With the rapid development of large language models and related technologies, various forms of patient modeling have emerged, including virtual patients, synthetic patients, artificial intelligence patients, and digital twin patients. Although these forms all share the core objective of patient simulation, they exhibit significant differences in theoretical ontology, data sources, modeling logic, and application orientation. Based on the abstraction levels of simulation objects and system mapping logic, this study systematically compares five paradigms—standardized patients, virtual patients, synthetic patients, AI patients, and digital twin patients—to clarify their conceptual boundaries and technical positioning. The findings indicate that these paradigms represent distinct modeling pathways: behavioral reproduction, scenario simulation, data generation, cognitive interaction, and individual system mapping, respectively. By constructing a multidimensional comparative framework, this study provides a theoretical foundation for the conceptual standardization of patient modeling and the strategic deployment of intelligent healthcare systems.

Objective:To explore the impact of the interaction between alcohol consumption and overweight/obesity on the risk of hypertension.Methods:It was a cross-sectional study, and convenient sampling was used to enroll physical examination participants aged 18-60 years from the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, the Affiliated Hospital of Southwest Medical University and Luzhou People′s Hospital from June to November in 2020. All the participants were given questionnaire survey, physical examination and biochemical tests. A total of 5 000 questionnaires were distributed in the study, and 4 878 questionnaires were collected, of which 4 397 (90.14%) were valid. According to the diagnostic criteria for hypertension, the study participants were divided into hypertension group (1 128 cases) and non-hypertension group (3 269 cases), and t-test and chi-square test were used to compare the differences in gender, age, and other data between the two groups; and multivariate logistic regression analysis was used to analyze the association of alcohol consumption, overweight/obesity with the risk of hypertension and the interaction between alcohol consumption and overweight/obesity on the risk of hypertension, and relative excess risk of interaction, attributable proportion of interaction and the synergy index were used to evaluate the impact of the interaction between alcohol consumption and overweight/obesity on the risk of hypertension. Results:Among the 4 397 individuals included in the analysis, 3 116 were male and 1 281 were female, with a mean age of (42.42±8.83) years. The detection rate of hypertension was 25.7% (1 128/4 397). The risk of hypertension in overweight/obese individuals was 2.566 times ( OR=2.566, 95% CI: 2.167-3.038) higher than that of non-overweight/obese individuals, and the risk of hypertension in alcohol consumption individuals was 1.486 times ( OR=1.486, 95% CI: 1.250-1.766) higher than that of non-drinkers. The risk of hypertension in drinking+non-overweight/obesity group, non-drinking+overweight/obesity group, and drinking+overweight/obesity group was 1.468 times ( OR=1.468, 95% CI: 1.112-1.936), 2.538 times ( OR=2.538, 95% CI: 1.968-3.272), and 3.796 times ( OR=3.796, 95% CI: 2.963-4.863) higher than that of non-drinking+non-overweight/obesity group, respectively (all P<0.05). Alcohol consumption and overweight/obesity had an additive interaction effect on the risk of hypertension, and the relative excess risk of interaction, attributable proportion of interaction and the synergy index was 0.791 (95% CI: 0.158-1.424), 0.208 (95% CI: 0.049-0.368), 1.394 (95% CI: 1.030-1.888), respectively. There was no significant multiplicative interaction between alcohol consumption and overweight/obesity on the risk of hypertension ( P>0.05). Conclusions:Alcohol consumption and overweight/obesity are both associated higher risk of hypertension. In addition, there is an additive interaction between alcohol consumption and overweight/obesity on the risk of hypertension.

Objective:To explore the impact of the interaction between alcohol consumption and overweight/obesity on the risk of hypertension.Methods:It was a cross-sectional study, and convenient sampling was used to enroll physical examination participants aged 18-60 years from the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, the Affiliated Hospital of Southwest Medical University and Luzhou People′s Hospital from June to November in 2020. All the participants were given questionnaire survey, physical examination and biochemical tests. A total of 5 000 questionnaires were distributed in the study, and 4 878 questionnaires were collected, of which 4 397 (90.14%) were valid. According to the diagnostic criteria for hypertension, the study participants were divided into hypertension group (1 128 cases) and non-hypertension group (3 269 cases), and t-test and chi-square test were used to compare the differences in gender, age, and other data between the two groups; and multivariate logistic regression analysis was used to analyze the association of alcohol consumption, overweight/obesity with the risk of hypertension and the interaction between alcohol consumption and overweight/obesity on the risk of hypertension, and relative excess risk of interaction, attributable proportion of interaction and the synergy index were used to evaluate the impact of the interaction between alcohol consumption and overweight/obesity on the risk of hypertension. Results:Among the 4 397 individuals included in the analysis, 3 116 were male and 1 281 were female, with a mean age of (42.42±8.83) years. The detection rate of hypertension was 25.7% (1 128/4 397). The risk of hypertension in overweight/obese individuals was 2.566 times ( OR=2.566, 95% CI: 2.167-3.038) higher than that of non-overweight/obese individuals, and the risk of hypertension in alcohol consumption individuals was 1.486 times ( OR=1.486, 95% CI: 1.250-1.766) higher than that of non-drinkers. The risk of hypertension in drinking+non-overweight/obesity group, non-drinking+overweight/obesity group, and drinking+overweight/obesity group was 1.468 times ( OR=1.468, 95% CI: 1.112-1.936), 2.538 times ( OR=2.538, 95% CI: 1.968-3.272), and 3.796 times ( OR=3.796, 95% CI: 2.963-4.863) higher than that of non-drinking+non-overweight/obesity group, respectively (all P<0.05). Alcohol consumption and overweight/obesity had an additive interaction effect on the risk of hypertension, and the relative excess risk of interaction, attributable proportion of interaction and the synergy index was 0.791 (95% CI: 0.158-1.424), 0.208 (95% CI: 0.049-0.368), 1.394 (95% CI: 1.030-1.888), respectively. There was no significant multiplicative interaction between alcohol consumption and overweight/obesity on the risk of hypertension ( P>0.05). Conclusions:Alcohol consumption and overweight/obesity are both associated higher risk of hypertension. In addition, there is an additive interaction between alcohol consumption and overweight/obesity on the risk of hypertension.

AIM: To study the distribution of CYP2C9∗3 and VKORC1-1639G>A gene polymorphism in Han population in Anhui province and their influence on the stable dose of warfarin. METHODS: The blood samples of 1 169 patients from 6 tertiary general hospitals in 5 areas of Anhui province from January 2020 to December 2021 were selected, the genotype of CYP2C9∗3 and VKORC1-1639G>A was detected by fluorescent staining in situ hybridization technique. RESULTS: The distribution of CYP2C9∗3 genotypes in 1 169 patients: the frequencies of AA, AC and CC genes were 90.16%, 9.24% and 0.60%, respectively; The distribution of VKORC1 genotype: the frequencies of AA, AG and GG genes were 84.26%, 14.71% and 1.03% respectively; There was no significant difference between the two genotypes in gender, age and regional distribution (P>0.05). The average daily warfarin dose of CYP2C9∗3 AA genotype in 755 patients with stable warfarin dose was (3.02±0.59) mg/d, which was significantly higher than patients with AC genotype and CC genotype; The average daily warfarin dose of patients with VKORC1-1639AA genotype was (2.72±0.40) mg/d, which was significantly lower than that of patients with AG genotype and GG genotype (P<0.05). And the difference was statistically significant (P<0.05); There are significant differences in gender, age and clinical diagnosis between patients with stable dose of warfarin and those without stable dose (P<0.05). CONCLUSION: CYP2C9 and VKORC1 genotypes are associated with the stable dose of warfarin. Clinical anticoagulation therapy guided by CYP2C9 and VKORC1 genotypes can provide guidance for individualized medication of warfarin.

To compare the representative novel coronavirus vaccine in the world at present and to provide a new and more comprehensive reference for the research and development of novel coronavirus vaccine. This review summarized the virological and immunological basis of novel coronavirus vaccine and made a detailed comparison and analysis of some representative vaccines based on different technologies and clinical trials in phase 2a/3. The immune effect of many kinds of novel coronavirus vaccines in phase 3 clinical trials around the world is encouraging, but the relationship between vaccine immunogenicity and safety and the reliability of clinical trial data still need to be paid close attention to. Designing new vaccine targets, inducing more extensive immune protection, improving immunogenicity, strict clinical trials and establishing large-scale cohort studies are higher requirements for novel coronavirus vaccine research and development.

A 63-year-old female patient received Ⅳ infusions of salvianolate,cattle encephalon glycoside,and pantoprazole and an intramuscular injection of diphenhydramine (only once) in Emergency Department for dizziness,nausea,vomiting,and weakness of lower limbs.Laboratory tests showed no abnormalities in liver function.Craniocerebral CT showed multiple lacunar ischemic demyelination and bilateral internal carotid atherosclerosis.The patient was diagnosed with lacunar cerebral infarction and admitted to hospital.On the night of admission,oral rosuvastatin calcium 10 mg/d and clopidogrel75 mg/d were given.Eleven hours later,laboratory tests showed aspartate aminotransferase (AST) 254 U/L and alanine aminotransferase (ALT) 157 U/L.Salvianolate and pantoprazole were discontinued and reduced glutathione was given.On day 3 of reduced glutathione treatment,laboratory tests showed AST 587 U/L and ALT 660 U/L.Rosuvastatin calcium-induced liver transaminase elevation was considered.Then rosuvastatin calcium was discontinued and compound glycyrrhizin was given.On day 9 of rosuvastatin calcium withdrawal,laboratory tests showed AST 112 U/L and ALT 201 U/L,and then reduced glutathione was discontinued.On day 15 of rosuvastatin calcium withdrawal,laboratory tests showed AST 42 U/L and ALT 63 U/L,and then compound glycyrrhizin was discontinued.The patient was discharged 4 days later.At 2 weeks of follow-up,no abnormalities in liver function were found in the patient.

A 63-year-old female patient received Ⅳ infusions of salvianolate,cattle encephalon glycoside,and pantoprazole and an intramuscular injection of diphenhydramine (only once) in Emergency Department for dizziness,nausea,vomiting,and weakness of lower limbs.Laboratory tests showed no abnormalities in liver function.Craniocerebral CT showed multiple lacunar ischemic demyelination and bilateral internal carotid atherosclerosis.The patient was diagnosed with lacunar cerebral infarction and admitted to hospital.On the night of admission,oral rosuvastatin calcium 10 mg/d and clopidogrel75 mg/d were given.Eleven hours later,laboratory tests showed aspartate aminotransferase (AST) 254 U/L and alanine aminotransferase (ALT) 157 U/L.Salvianolate and pantoprazole were discontinued and reduced glutathione was given.On day 3 of reduced glutathione treatment,laboratory tests showed AST 587 U/L and ALT 660 U/L.Rosuvastatin calcium-induced liver transaminase elevation was considered.Then rosuvastatin calcium was discontinued and compound glycyrrhizin was given.On day 9 of rosuvastatin calcium withdrawal,laboratory tests showed AST 112 U/L and ALT 201 U/L,and then reduced glutathione was discontinued.On day 15 of rosuvastatin calcium withdrawal,laboratory tests showed AST 42 U/L and ALT 63 U/L,and then compound glycyrrhizin was discontinued.The patient was discharged 4 days later.At 2 weeks of follow-up,no abnormalities in liver function were found in the patient.

Objective To explore the expression of aquaporin 4 (AQP4) in primary and secondary cultured rat astrocytes. Methods Rat cortical astrocytes from a newborn (one day) Wistar rat were cultured. Astrocytes were identified with immunofluorescence staining of glial fibrilillary acidic protein (GFAP). The expression of AQP4 was determined with real-time quantitative polymerase chain reaction and immu-nofluorescence staining three, five, seven and nine days of primary culture, and nine days of secondary culture. Results The purity of GFAP-positive cells was more than 95％. The expression of AQP4 mRNA was found three days of primary culture, remained unchanged five days of primary culture (P>0.05), and increased seven and nine days of primary culture (P<0.05). The expression of AQP4 mRNA was not different between nine days of primary culture and nine days of secondary culture (P>0.05). AQP4 immunofluorescence staining showed the same trend of AQP4 mRNA. Conclusion AQP4 may express since three days of primary culture in rat astrocytes in vitro, and increase slowly until nine days of primary culture.

Objective To investigate the expression changes of astrocytic syntrophin in hippocampus from human mesial temporal lobe epilepsy (MTLE). Methods From April, 2015 to July, 2016, 17 cases of hippocampus, collected from temporal lobectomy, were divided into MTLE group (n=13) and non-MTLE group (n=4) according to hematoxylin and eosin staining, glial fibrillary acidic protein and neuronal nu-clei immunohistochemical staining. Immunofluorescence double labeling and immunofluorescence histochemistry were used to observe the expression of syntrophin. Results The proliferation of astrocytes increased and neurons reduced in the hippocampus of MTLE group. Syntro-phin was found in the membrane and foot processes of astrocyte, that was enriched along perivascular astrocyte end-feet domain in non-MTLE group, but lost in MTLE group. While the whole expression of syntrophin was more in MTLE group than in non-MTLE group (t=5.421, P<0.001). Conclusion The distribution of syntrophin in hippocampus astrocytes may be related to the development of MTLE.